法国抗逆转录病毒治疗的启动：对国家指南的依从性及结果

Antiretroviral therapy initiation in France: adherence to national guidelines and outcome.

作者信息

Latthaphasavang Vatthanaphone, Bouldouyre Marie-Anne, Rachline Anne, Ponscarme Diane, Rozenbaum Willy, Mary Jean-Yves, Delaugerre Constance, Molina Jean-Michel

机构信息

1Department of Infectious Diseases, Saint Louis Hospital, AH-HP, and University of Paris Diderot, Paris, France.

出版信息

J Int Assoc Physicians AIDS Care (Chic). 2012 Jan-Feb;11(1):40-6. doi: 10.1177/1545109711418362. Epub 2011 Aug 31.

DOI:10.1177/1545109711418362

PMID:21880977

Abstract

OBJECTIVES AND METHODS

Retrospective study of all patients who started antiretroviral therapy (ART) in 2007 in a single center in Paris, with baseline characteristics and 1-year outcome, to assess adherence to national guidelines.

RESULTS

We analyzed 118 patients. Time of ART initiation was in agreement with the guidelines for only 64 (54.2%) patients. Fifty patients (42%) started ART with AIDS or a CD4 count <200 cells/mm(3). In all, 62 (52%) and 47 patients (40%) received a combination of 2 nucleoside analogues with efavirenz (EFV) and 1 ritonavir-boosted protease inhibitor (PI/r), respectively. Treatment regimens were in accordance with the guidelines for 114 patients (97%). At 1 year, 16 patients (13.5%) were lost to follow-up, only 5 (4.9%) experienced HIV disease progression or death, but 19 (18.6%) required hospitalization. Antiretroviral therapy was changed in 21 patients (21%). Ten patients (8.4%) experienced virologic failure.

CONCLUSION

Antiretroviral therapy was in agreement with guidelines for the choice of combination but was often initiated too late.

摘要

目的与方法

对2007年在巴黎某单一中心开始抗逆转录病毒治疗（ART）的所有患者进行回顾性研究，分析其基线特征及1年治疗结果，以评估对国家指南的依从性。

结果

我们分析了118例患者。仅64例（54.2%）患者的ART起始时间符合指南要求。50例（42%）患者在患艾滋病或CD4细胞计数<200个/mm³时开始ART治疗。共有62例（52%）和47例（40%）患者分别接受了2种核苷类似物与依非韦伦（EFV）及1种利托那韦增强型蛋白酶抑制剂（PI/r）的联合治疗。114例（97%）患者的治疗方案符合指南要求。1年后，16例（13.5%）患者失访，仅5例（4.9%）出现HIV疾病进展或死亡，但19例（18.6%）患者需要住院治疗。21例（21%）患者的抗逆转录病毒治疗方案发生了改变。10例（8.4%）患者出现病毒学失败。